Vicky St John, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP129324 Issued in TX

Practice address

315 W Houston St
Jasper, TX 75951-4013

Phone

(409) 384-3430

Fax

(409) 383-1054

NPI assigned

Oct 13, 2015

Last updated

Oct 27, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deep East Texas Maternal and Family Health PAGroup PAC ID 7113958539, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advantage Plus Homecare Home health agency, Jasper, TX, CCN 679159
• Christus Jasper Memorial Hospital Hospital, Jasper, TX, CCN 450573
• Rayburn Health Care & Rehabilitation Nursing home, Jasper, TX, CCN 676269

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HDDADA
• FHIR API: https://fhir4.healow.com/fhir/r4/HDDADA/Endpoint/HDDADA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Deep East Texas Maternal & Family Health PA

  dba Complete Healthcare Services PA

  • Family Medicine Physician
  • Jasper, TX
  • NPI 1043307986
  Medicare reassignment Care Compare group NPD
• Sound Physicians Emergency Medicine of Texas PLLC

  • Emergency Medicine Physician
  • Killeen, TX
  • NPI 1518475557
  Medicare reassignment NPD
• Southern Nurses Inc.

  dba Lakeside Lodge Assisted Living

  • Assisted Living Facility
  • Brookeland, TX
  • NPI 1598223141
  NPD Authorized official
• Complete Healthcare Services RHC PLLC

  dba Complete Healthcare Services RHC - Jasper

  • Rural Health Clinic/Center
  • Jasper, TX
  • NPI 1912091778
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advantage Plus Homecare, Inc.

  dba Advantage Plus Homecare

  • Home Health Agency
  • Jasper, TX
  • NPI 1194760165
  Care Compare affiliation
• Christus Health Southeast Texas

  dba CHRISTUS Southeast Texas - Jasper Memorial

  • Rural Acute Care Hospital
  • Jasper, TX
  • NPI 1598749707
  Care Compare affiliation
• Sweet Neches Properties, LTD.

  dba Rayburn Health Care & Rehabilitation

  • Skilled Nursing Facility
  • Jasper, TX
  • NPI 1962710079

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1033580394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W HOUSTON ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514013",
            "telephone_number": "409-384-3430",
            "fax_number": "409-383-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W HOUSTON ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514013",
            "telephone_number": "409-384-3430",
            "fax_number": "409-383-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST JOHN",
        "first_name": "VICKY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP129324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Solitude Emergency Physicians, PLLC
• Southeast Texas Dental Center
• James Berthold Spencer, M.D.
• Steven G. Spencer, DDS
• Jimmy W. Spruill, M.D.
• Stat Services of Jasper County a, LLP (Stat Care EMS)
• Stat Services of Jasper County a, LLP (Stat Care EMS)
• Sweet Neches Properties, LTD. (Rayburn Health Care & Rehabilitation)
• Brent Parker Tanksley, LCDC
• Tatum Family Counseling PLLC

• Family Nurse Practitioner in Jasper, TX
• Providers in Jasper, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.